Abstract
COVID-19 is strongly influenced by age and comorbidities. Acute kidney injury (AKI) is a frequent finding in COVID-19 patients and seems to be associated to mortality and severity. On the other hand, the role of kidney dysfunction in COVID-19 is still debated. We performed a retrospective study in a cohort of 174 hospitalized COVID-19 patients in Italy from March 3rd to May 21st 2020, to investigate the role of kidney dysfunction on COVID-19 severity and mortality. Moreover, we examined in depth the relationship between kidney function, age, and progression of COVID-19, also using different equations to estimate the glomerular filtration rate (GFR). We performed logistic regressions, while a predictive analysis was made through a machine learning approach. AKI and death occurred respectively in 10.2% and 19.5%, in our population. The major risk factors for mortality in our cohort were age [adjusted HR, 6.2; 95% confidence interval (CI) 1.8–21.4] and AKI [3.36 (1.44–7.87)], while, in these relationships, GFR at baseline mitigated the role of age. The occurrence of AKI was influenced by baseline kidney function, D-dimer, procalcitonin and hypertension. Our predictive analysis for AKI and mortality reached an accuracy of ≥ 94% and ≥ 91%, respectively. Our study scales down the role of kidney function impairment on hospital admission , especially in elderly patients. BIS-1 formula demonstrated a worse performance to predict the outcomes in COVID-19 patients when compared with MDRD and CKD-EPI.
【초록키워드】 COVID-19, Mortality, Kidney function, severity, Comorbidities, COVID-19 severity, D-dimer, procalcitonin, progression, outcome, Italy, risk factor, elderly patients, hypertension, Kidney injury, Retrospective study, Cohort, AKI, Accuracy, death, age, Hospital admission, predict, glomerular filtration rate, hospitalized COVID-19 patient, Analysis, COVID-19 patient, Predictive, 95% confidence interval, kidney dysfunction, impairment, logistic regressions, approach, Occurrence, performed, occurred, examined, demonstrated, reached, GFR, baseline, 【제목키워드】 COVID-19, age, kidney dysfunction,